One of the silent diseases in the female population, endometriosis can be symptomless for years and sometimes even decades, but can sometimes manifest itself quickly. The uterus is lined on the inner side by a tissue known as endometrium. When this tissue is found in other parts (fallopian tubes, abdomen, near the ovaries, etc., it is known as endometriosis.

Causes: The exact cause for endometriosis is not clear. There is a possibility that during the regular period, there could be spilling of the tissue back into the fallopian tube, from where it reaches the ovaries or other organs and gets implanted.

There are certain predisposing factors for a woman to develop this condition, including genetic correlation and non-menopausal women. The female hormone estrogen is essential for the development of endometriosis. There are also immunological reasons attributed to the development. It can range from minimal to mild to moderate to severe.

Symptoms: From being completely benign to causing severe pain, endometriosis can present itself in varying ways. The implanted tissue can be minimal like a small lump to large clumps. The symptoms are not dependent on the size of the implanted tissue, however, 

1. Painful menstruation: One of the most common causes of non-menstrual cramps, the pain is different from usual menstrual pain, starts a few days before the period and can last up to after the period.

2. Pelvic pain: One of the most common causes of pelvic pain, this can happen wherever the implanted tissue is. In severe cases, this tissue can also bind different organs, forming what are called adhesions. The bladder or the bowels may adhere to the uterus. These are more painful than individual lumps of tissue outside the uterus.

3. Intermenstrual bleeding: There could be spotting to severe bleeding between the regular cycles.

4. Painful sex: There is a deep pain within the pelvis and it can lead to losing interest in sex.

5. Infertility: The most severe symptom and complication is not being able to become pregnant.

Diagnosis: A detailed patient history, discussion on symptoms followed by ultrasound and laparoscopy can help in diagnosing endometriosis.

Treatment: If there is no symptom and fertility is not an issue, then it is possible that no treatment is required. However, depending on symptoms and complications, the following are done.
- If pain is the only main problem, painkillers are administered
- Surgical treatment may be required if there is severe bleeding and adhesions complicating the situation. 

This will also relieve other symptoms
1. Hormone therapy is also an option for treating endometriosis.
2. If you are having pelvic pain and irregular bleeding, bring it up with your doctor. Even if it is not endometriosis, a thorough check up will put your mind at rest.

Endometriosis and Complications Associated With It

While some couples conceive with ease, conceiving a child can be extremely difficult for others. In cases where a woman is not able to get pregnant despite having regular intercourse in tune with her biological cycle, infertility tests may be suggested to investigate the reason behind this. In most cases, these tests are suggested if a year has gone by without intercourse resulting in a pregnancy. Women may also be said to be infertile, if they cannot carry a foetus to full term. 

Infertility can affect both men and women and can be triggered by a number of different reasons. In some cases, it is treatable while in others, alternative ways of having a family may need to be discussed. Hence, it is very important to understand the different types and triggers for infertility and to undergo complete infertility investigations. Some of the common types of infertility investigations are as given below.

Blood tests: A blood test of both partners is used to assess the general health of the couple and to identify any health factors that may be impeding fertility.
Tests for women: 
Hysterosalpingogram: This is an X ray that can identify if a blockage or any other issue in the fallopian tubes are the cause for infertility.
Pelvic ultrasound: This is used to have a look at the anatomy of the female reproductive system and to check for fibroids.
Laparoscopy / hysteroscopy: This is used to get a clearer picture of the ovaries, uterus and other parts of the reproductive system.
Tracking cycle: Ovulation and the thickness of the uterus lining may also affect infertility, This can be diagnosed by tracking and assessing the menstrual cycle.
Tests for men
Semen analysis:This test is used to get an idea of sperm concentration, motility and the appearance of sperm in a man s semen. In some cases, the semen may not include any sperm cells. In such cases, a follow up investigation may be required to assess if sperm cells are being created in the testicles. This is known as testicular sperm aspiration or a testicular biopsy.
Sperm DNA: The DNA in sperm also plays an important role in fertility. This test is used to assess the sperm DNA integrity and to see how it may affect embryo development and chances of an on-going pregnancy.
Infertility treatment depends on the cause identified by the above tests and hence it is important for both partners to undergo complete testing.

Complete Infertility Investigation - Why is It Important?

C-section or Caesarean section is a surgery performed to deliver a baby. The baby is taken out from the abdomen through an incision in the abdominal wall. This surgery is performed when there is some sort of physical difficulty in natural childbirth through the vagina. Other reasons for performing a C-section are when the mother is carrying more than one baby, or the health of the baby is in danger. It could also be because of an undesirable fetal position, or when the mother is physically unable to push the baby out of the uterus. 


Procedure followed in C- Section
The procedure is most often done when the mother is in her senses and awake. However, epidural or spinal anaesthesia is provided to numb the body from chest to the feet, before the surgery is performed.


An incision is made on the lower abdomen, above the pubic area. A cut is made through the uterus and amniotic sac. The baby is pulled out from this opening. The umbilical cord is cut and cleaned. The fluids are cleaned from the baby s mouth and nose. The infant s breathing rate, heart rate and other vitals are kept under observation. 


Recovery from a C-section can take several weeks. The stitch wounds need to heal, including the recovery of pelvic muscles. It is important to walk around and do some very light exercises to boost the healing procedure. Doctors may prescribe painkillers in some cases and advice on effective post-operative care. Though the surgical procedure is quite safe now, with the use of highly advanced technology, there are risks that cannot be entirely ignored. 


Risks associated with C-section
Infections: Any surgery has some risk of infection associated to it. In the case of a C-section, an infection can occur around the site of incision that may rapidly spread in the uterine wall and other internal pelvic organs.
Haemorrhage: Blood refuses to clot and dangerously high quantity of blood is lost in the process. In such a case, it requires immediate transfusion and intensive care.
Injuries: The mother or the baby, both have a risk of getting injured during the surgery. Although these are rare, but the infant may suffer nicks and cuts while being manually pulled out from the womb. Other organs of the mother located near the pelvis may suffer minor or major wounds.


After the C-section, the mother and child will be retained in the hospital for 2 to 3 days, under intense care and constant monitoring. It is important to exercise and take the medications as advised by the physician to prevent any complication. 

C- Section - Understanding the Procedure and Risks

Menopause automatically brings about a dip in testosterone and estrogen levels in a woman s body. It leads to certain changes in the body and also reduces libido. A drop in libido means that sexual arousal becomes a cause of concern. This can bring in certain problems in your sexual/conjugal life. Lower estrogen levels reduce supply of blood to the vagina, thus resulting in lubrication problems. A dry vagina during sexual intercourse can lead you to experience pain during sex.

There are some other factors that can affect a woman s libido after menopause:
1. Problems in sleep
2. Anxiety and depression
3. Problems of the bladder
4. Certain medications
5. High stress levels

To remedy lubrication problems, use water soluble lubricants to lubricate your vagina. Avoid using non-water soluble products such as petroleum jelly as it can weaken the latex. Non water soluble lubricants are also known to aggravate bacterial vaginosis. You may also use vaginal moisturizers to address the issue. There are oral medications that are available, which cause the tissues of the vagina to thicken, thus causing less pain during sex.

Improving your libido
You can opt for estrogen therapy to reduce pain during sex as this therapy helps in vaginal lubrication. The main objective of estrogen therapy (Hormone Replacement Therapy) is to ease the discomforts associated with a deficiency of estrogen secretion in the body. You should consult a professional who will be able to guide and counsel you.

Certain other measures to rev up your libido have been listed below:

    Indulge in foreplay: Try and include activities such as oral sex and erotic massages in your agenda. Experimentation with foreplay can help spice things up between you and your partner.
    Try out new things: Change your sex poses, read erotic books or watch erotic videos as these may help in boosting your libido.

Bear in mind that menopause does not prevent STDs; you still need to take proper precautions before engaging in sexual intercourse. 

How to Improve Your Libido Post Menopause 

Sexual intercourse for humans is not only a reproductive act, but is also considered to be an emotional and pleasurable act. However, statistics report that almost 30% of the women experience pain during intercourse also known as vaginismus. This not only hampers the pleasure, but is also an unhealthy sign since it is indicative of a problem.

Vaginismus / Painful intercourse could be a regular occurrence, or a sporadic one. There could be numerous reasons that cause the discomfort and pain. Though it might be an early manifestation of grave diseases such as endometriosis or fibroids, but more often, it is triggered due to conditions such as vaginal dryness, yeast infection, bacterial vaginiosis, which can be easily treated. It is pertinent to understand that it is not the physical infirmity of the entire female anatomy that causes such pain/ discomfort, but the existence of certain conditions that can be treated by a medical practitioner. 

Certain such causal factors associated with painful intercourse and the efficient ways to deal with them are discussed below:

Vaginal dryness- Vaginal dryness is one of the most commonly cited causes for painful intercourse. There are various causal factors of vaginal dryness. These include, but are not limited to, consumption of certain drugs, bathing with hot water, health conditions or even lack of foreplay. Vaginal dryness due to the aforementioned causes is a short-lived condition that can be treated well with the help of a medical practitioner. Usage of lubricants that is suitable for you, as advised by a medical practitioner, could go a long way in aiding the ease of sexual intercourse. The lubricants act as an effective substitute, if the body is unable to naturally secrete vaginal fluids to ease intercourse, thereby greatly reducing the pain that is experienced.

Improper vaginal expansion- The female anatomy is designed in such a way that it expands normally during intercourse. Proper foreplay enables the woman to get excited, which results in the release of vaginal fluids that aids in sexual intercourse. However, in the event that the female is not excited enough prior to the act, sexual intercourse can become a painful act, since the vagina is unable to expand in the absence of vaginal fluids. In such cases, take things slow and give your body time to comfortably go with the flow.

Vaginal itching caused by infection- Vaginal infections can be caused by antibiotics, prior sexual activity that has resulted in contraction of Sexually Transmitted Diseases etc. This results in an itching or burning sensation while having sex. It is essential to rest your body instead of forcing things, and to consult your doctor as soon as possible. The doctor can correctly diagnose the causal factors behind the infection, and prescribe the necessary medicines for it.

Emotional issues including fear of sex, marital issues/ disputes, etc are also leading cause of painful sex

Treatment:

However, symptoms vary from the common ones mentioned above, it is always advisable to consult a experienced doctor including a gynecologist, sexologist or sexual counselor.

Role of sexual counselor is very important, as he she can offer Sex therapy in the form of counseling, brief psychoanalysis, or behavioural therapy .This can help to address any underlying psychological issues, such as fear or anxiety, tackle any irrational beliefs that you have about sex, educate you about sex.

Also some special techniques can be taught eventually stop your vagina closing involuntarily, such as using vaginal trainers and pelvic floor exercises

If you wish to discuss about this problem, you can consult a doctor and ask a question.

Vaginismus - Make Sex Less Painful For Your Lady!

Keeping track of your cycle probably doesn't sound that interesting or important, but you can benefit a lot by doing that. There are changes that your body goes through and there are specific times when you are ovulating; knowing all these would make your life a lot easier, which is only possible by tracking your period.

1.   Know about your body: Getting your period every 28 days has always been considered normal but only 15% of women get their periods on the clock. Many factors such as stress, illness, exercise, etc. can cause delay in  your period. This is where tracking your cycle can help you find the pattern that is specific to your body condition. During your cycle there are lots of changes happening in your body. The hormones cause a change in the fluid produced from your cervix and also lead the basal temperature of your body to increase. Monitoring these changes through tracking your cycle is known as the symptothermal method. By this way you know about how fascinatingly your body works.

2.   Desire to get pregnant: Tracking your cycle will help you get pregnant. During your cycle, there is a specific time which heightens the possibility of conceiving. The fluid production from the cervix due to hormonal change is the cause of such possibility. Knowing your cycle can take out the stress from trying to get pregnant and it can also help determine any abnormalities that are preventing your pregnancy.

3. Avoid pregnancy: If you know the time when you are most likely to get pregnant through tracking, you obviously know when not to have sex, if you are trying to avoid pregnancy. Using symptothermal method for the purpose of birth control has proven to be 99.6% effective, which is higher than birth control medications.

4. Health benefits: You can reap a lot of health benefits by tracking your cycle. Conditions like fibroids, polycystic ovarian syndrome and endometriosis are quite common in women, which can be detected by tracking your period. If anything is wrong in your reproductive system, the cycle will indicate it.

4 Reasons To Keep Track Of Your Periods

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